A nursing unit is undergoing changes to accommodate new bariatric services that will be available on the unit. Some staff members have verbalized displeasure with the changes. Which of the following actions should the charge nurse take?

The correct answer is choice B: "Ask the client to explain the procedure that is being performed."

Choice A rationale:

While verifying that the client understands the risks of the surgery (Choice A) is important, the question specifically asks about verifying informed consent. Informed consent involves ensuring that the patient comprehends the procedure being performed, its benefits, risks, and alternatives. While understanding the risks is a part of this, it's not the complete picture.

Choice B rationale:

The correct response is "Ask the client to explain the procedure that is being performed." This approach ensures that the client truly comprehends the procedure and its implications. If the client can accurately explain the procedure, it indicates a better understanding of what they are consenting to, which aligns with the concept of informed consent.

Choice C rationale:

Answering the client's questions about the outcomes of the surgery (Choice C) is important for providing education and addressing concerns, but it doesn't directly verify informed consent. The focus of informed consent is on the procedure itself, including its nature, purpose, and potential risks.

Choice D rationale:

Determining if the client understands the benefits of the procedure (Choice D) is only part of the informed consent process. While understanding the benefits is essential, it's equally important to ensure the client comprehends the risks and alternatives, which is better assessed by having the client explain the procedure.

Answer is b. Frequent use of restroom.

a. Spends free time conversing with other staff at the nurses' station: Socializing with colleagues during free time at the nurses' station is a common and acceptable behavior in many healthcare settings. While excessive socializing could potentially interfere with productivity, it does not necessarily indicate impairment. Engaging in conversations with coworkers can serve as a stress-reliever and contribute to a supportive work environment, rather than being a sign of impairment.

b. Frequent use of restroom: Correct. Frequent restroom use can be a red flag for substance abuse or other health issues. Individuals who are working while impaired may frequently visit the restroom to use drugs, manage their effects, or experience side effects of substance use. This behavior may be a tactic to conceal substance abuse from coworkers or supervisors, as frequent restroom breaks could be perceived as a normal bodily function. Therefore, the charge nurse should pay close attention to staff members who exhibit a pattern of frequent restroom use, especially if there are other signs of impairment or behavior changes.

c. Depends on other nurses to administer pain medication to their clients: While relying on other nurses to administer pain medication to clients could potentially raise concerns about the staff nurse's competence or workload management, it does not necessarily indicate impairment. There could be various reasons for a nurse to delegate medication administration tasks, such as being assigned to other critical tasks, adhering to hospital policies, or seeking assistance during busy periods. Without further evidence or observation of impaired behavior, depending on others to administer medications cannot be solely attributed to working while impaired.

d. Delegates tasks to assistive personnel: Delegating tasks to assistive personnel is a standard nursing practice and does not inherently suggest impairment. Nurses often delegate tasks to other healthcare team members, including certified nursing assistants or patient care technicians, to ensure efficient and effective patient care delivery. Delegation is guided by nursing standards, patient acuity, and the scope of practice of assistive personnel. Therefore, observing a nurse delegating tasks alone is not sufficient evidence to suspect impairment.

In summary, the correct answer is b because frequent use of the restroom can be indicative of substance abuse or other health issues, especially when observed in conjunction with other signs of impairment or behavior changes. The charge nurse should carefully monitor and investigate any concerning behaviors displayed by staff nurses to ensure patient safety and provide appropriate support and intervention.